The Effect of the Anxiety State before and After Acl Reconstruction on the Treatment Success

Background: Anterior cruciate ligament (ACL) rupture is a frequent and incapacitating injury of the knee that occurs in active people. The incidence of ACL patients has been increasing during last few decades, in particular with young patients under the age of 25, due to elevation in sport demands, the intensity and also due to MRI availability. The treatment for ACL rupture is usually surgical reconstruction.

Our hypothesis suggests a negative correlation between the patient’s anxiety and the surgical outcomes- higher depression and anxiety rates bring to a decline in the surgical outcome.

Methods: A prospective study of 22 patients over 1 year. The patients scheduled to over go ACL reconstruction are examined physically and mentally by appropriate questionnaires. The questionnaires are filled before the procedure, and 4 times during the rehabilitation: 6 weeks after the procedure, 3, 6 and 12 months after the procedure. The questionnaires that were filled are: State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), Short Form 36 (SF36), Lysholm (knee function).

Results: Significant improvements were found in the Lysholm scores, the Physical Component Summary (PSC) of the SF36, the Mental Component Summary (MSC) of the SF36 score. A significant correlation between the Lysholm score and the STAI score was found: after six months the correlation coefficient was -0.659 (p=0.001) and after a year the correlation coefficient was 0.559 (p=0.012). A correlation was found between the Lysholm and the BDI score (R=-0.772, p<0.0001).

Another correlation was found between the PSC of the SF36 score and the BDI score (R=-0.60, p=0.005).

Conclusions: The mental state before and after ACL reconstruction effects the surgical outcome and physical functioning of the knee.